The Relationship between Attention and Emotion Regulation in Attention-Deficit/Hyperactivity Disorder

Abstract

ADHD is characterized by deficits in cognitive control, but these deficits are heterogeneous, only accounting for a small percentage of symptom variability. Recent empirical evidence supports the incorporation of emotion dysregulation (ED) as an additional core symptom domain. Accordingly, ADHD has been contemporarily described as a disorder of deficient overall self-regulation, encompassing both cognitive and emotional control domains. Attention, a mechanism underlying self-regulation development, may play a prominent role in ED in ADHD. Basic emotion regulation strategies utilized during childhood rely upon both selective and sustained attention. These mechanisms are deficient in ADHD though significant heterogeneity exists. The aim of this study was to elucidate whether attention and ED are associated in 7- to 9-year-old children with symptoms of ADHD; a total of 34 children participated. Diagnoses were determined using a semi-structured parent interview. Attention was measured using two computerized tasks. ED was measured using a computerized frustration task as well as a parent-report questionnaire. Overall, we identified relationships between attention and ED in children with symptoms of ADHD that varied depending upon the type of attention and measure of ED. Poorer sustained attention was associated with greater laboratory-measured ED, whereas poorer selective attention was associated with greater parent-reported ED. Our findings provide initial insight into the subtleties of the relationship between deficits in attention and ED in ADHD. For example, ED as evidenced by less persistence on a laboratory frustration task (perhaps due to less ability to tolerate distress) was associated with poorer sustained attention. Thus, an increased inability to sustain attention on a specific emotion-regulation strategy (e.g. distraction) and/or on the specific task-at-hand, may have contributed to the child’s likelihood of quitting the task. Our parent-reported measure of ED may have instead tapped into a child’s response to their environment and outward display of negative emotion. Children who had less control over their selective attention were more likely to display observable negative emotions. If our present findings can be replicated and confirmed, this data might provide evidence that treating specific attentional deficits (selective and sustained) may directly impact ED symptoms.^